Vitality tests of the teeth

The tooth should be examined for vitality by several tests:

The cold test

This is simply done with cylindrically shaped ice sticks. Keep them in the freezer and withdraw the frozen cylinder when needed. A good site of cold application is generally the buccal surface as close to the cemento-enamel junction as possible If a tooth has irreversible pulpitis it will either give a prolonged response, possibly after some delay, or no response. Transient pain (less than ten seconds) after the application and removal of ice is normal. No response may mean the tooth is endodontically involved, especially if all other teeth respond to cold. If sharp transient pain occurs that is greater than the pain felt in surrounding teeth, check to see if the bite is high. Root canal is probably not needed and the bite adjustment will eliminate the hyper response to cold.

The heat test

Using a ball of hot gutta percha on the tip of a plastic instrument, place the gutta percha onto the tooth the same way you would the ice. Wait approximately 15 seconds between teeth to assess the possibility of a delayed, but, prolonged response. Compare the results from other tested teeth. If one tooth gives a prolonged response, whether immediate or delayed, it is a most suspicious candidate for endodontics. If the pain is immediately relieved by cold, the tooth probably needs root canal.

The electric pulp test (EPT)

This test should be used when the hot and cold tests fail to give clear information on the state of vitality of the tooth. Again, the information supplied by the electric pulp test must be weighed against the response from other teeth. The fact that a tooth does not respond to the EPT has little meaning if all the other teeth also do not respond, unless of course this is the only tooth with a well-defined area at the apex or is quite tender to percussion.

Ex.16. Fill in the questionnaire (anamnesis). Make up a dialogue based on your answers.

Name: ________________________________________________________________________

Date of birth:___________________________________________________________________

Occupation: ___________________________________________________________________

Telephone: ___________________________________________________________________

E-mail: ______________________________________________________________________

For an effective treatment and to avoid possible complications, please answer the following

questions:

1. Have you had any changes in your health in the past year?  Yes  No

If yes, what?____________________________________________________________

2. Have you been hospitalzed in the last three years?  Yes  No

If yes, why?_____________________________________________________________

3. Your blood pressure is:.  normal  unstable  high  very high

4. Do you smoke?  Yes  No

If yes, how many a day?___________________________________________________

5. Do you suffer (or have you suffered) from (any):

- heart and/or circulatory disease?  Yes  No

- hemophilia?  Yes  No

- diabetes?  Yes  No

- liver-, gall complaints or jaundice?  Yes  No

- contagious disease (TBC, syphilis, AIDS)  Yes  No

- respiratory disease or asthma  Yes  No

- nervous disease?  Yes  No

- dizziness, fainting, spasms, indispostion?  Yes  No

- allergies, hypersensitivity?  Yes  No

If yes, to what?__________________________________________________________

6. Any further complaints or illnesses which might be important for us to know?

____________________________________________________________________________

____________________________________________________________________________

7. Any operations you have had:

____________________________________________________________________________

____________________________________________________________________________

8. Medicines you regularly take:

____________________________________________________________________________

____________________________________________________________________________

9. Have you in the past few weeks taken any other medication besides these?  Yes  No

If yes, what?____________________________________________________________

Acute troubles:

10. Do you have pain in mouth or teeth?  Yes  No

If yes, where? when? appearing? since when?:__________________________________

_______________________________________________________________________

Dental anamnesis / case history:

11. Which kind of dental treatments have been carried out in the last 3 years?

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

Jaw:

12. Troubles/pain in jaw?  Yes  No

13. Is there any cracking noise, gnashing or rubbing?  Yes  No

If yes, which side?________________________________________________________

14. Teeth in right position when biting?  Yes  No

15. Limitation of movement when opening the mouth or moving to one side?  Yes  No?

16. Chronic headache?  Yes  No?

If yes, how often? where (region)?____________________________________________

17. Pain in cervical vertebra, neck and shoulders?  Yes  No?

3

18. Chronic ear infections, pain, tinnitus etc?  Yes  No

19. Problems with eyes, strong visual disorder, high eye pressure etc?  Yes  No

20. Orthodontic treatment in the past?  Yes  No

If yes, please give details:

_____________________________________________________________________________

_____________________________________________________________________________

21. Have you ever worn braces?  Yes  No

If yes:  fixed  removable

22. Have you had depuration?  Yes  No

The last time you had it was:_______________________________________________

23. How often do you brush your teeth a day?_______________________________________

24. Do you regularly use dental floss?  Yes  No

Date:___________________ Signature:______________________

Ex.17. Translate into English:

1. Щоб поставити правильний діагноз, необхідно зібрати якнайбільше інформації про стан здоров'я пацієнта. 2. При огляді пацієнта стоматолог звертає увагу на колір обличчя, його симетричність, стан шкіри, на мовлення та жувальні рухи. 3. Для обстеження ротової порожнини необхідні добре освітлення, стоматологічне дзеркальце та зонди. 4. Інколи візуального огляду не достатньо, щоб поставити остаточний діагноз.

Overview

Case history is a planned professional conversation that enables the patients to communicate their symptoms, feelings and fear complex to the physician. The following elements should be included in the dental history: past dental visits, oral hygiene practices, oral symptoms, past dental or maxillofacial trauma, habits related to oral disease, dietary history. Clinical examination of the patient includes general examination, extra-oral examination, intra-oral examination. Different techniques of clinical examination are used by the dentist including visual inspection, palpation, probing, percussion, etc. All bits of information obtained in the history and examination process are called findings. The written record is a working document of all findings. Diagnosis is an assessment of the findings which specifies what is happening to a patient and why. Treatment plan is the end product of data gathering and diagnosis.

Lesson 15

Dental radiography